The Voice of Podiatrists

Serving Over 10,900 Podiatrists Daily

June 18, 2008 #3,275 Editor-Barry Block, DPM, JD

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We've just mailed the June/July 2008 Podiatry Management. This 268 page issue is filled with interesting, informative, and useful articles. You'll also find our usual assortment of features, including our columns, and a CPME-approved CME.

June/July 2008 Podiatry Management

Fungus Nails on the Rise: MA Podiatrist

"I see a lot of patients, even compared to five years ago, who come in and say I got a nail fungus - I picked it up at the salon," said Martin Harris, DPM, an Attleboro-based podiatrist. "My ability to say with 100 percent certainty that it is or is not from the salon is difficult. But certainly, it's possible."

Dr. Martin Harris

Harris said there aren't statistics available - because of difficulty in tracing the origin of a nail fungus - as to how many are contracted at nail salons, but they can be picked up anywhere and that includes spas where toes are buffed and polished.

Harris said that those who are more likely to develop an infection might have had recent trauma to their nail. "It could have been then that their resistance was down," he said. "Which basically is a reflection of their overall medical health. That could have come from a tight shoe, bumping it or a sport they are involved with."

Source: Rebecca Keister, Sun Chronicle

Fourth World Union Symposium Draws 5000

Nearly 5,000 people from 70 nations convened in Toronto last week for the Fourth World Union of Wound Healing Societies Symposium. Held every four years, this is the world's leading multinational symposium in its field.

From left: Professor Jan Apelqvist, Lund, Sweden Steven Kravitz, DPM, Robert Frykberg, DPM, MPH, Professor AJM Boulton, Manchester, UK and Professor David G. Armstrong

Several well-known members of the international diabetic foot/amputation prevention community served as “captains” and headed up the diabetic foot symposium.

NY Podiatrist, Former Classmate of Tim Russert, Mourns Loss

Four years ago, Tim Russert put us all to shame when he gave his dad the best, most heartfelt gift a child could ever present to his or her father. He wrote “Big Russ & Me, Father and Son: Lessons of Life,” a 336-page ode to Timothy J. Russert Sr., the man who steered him through life with his scrappy South Buffalo wisdom and salt-of-the-earth Irish Catholic values. So it was all the more devastating for Tim Sr. to learn Friday that his son had died suddenly of a heart attack — two days before Father’s Day.

Tim Russert

“His book, which speaks volumes, was a testimony to his devotion to his father,” said Michael Hanzly, a South Buffalo podiatrist who went to Canisius High School and worked at the rectory at St. Michael Church in downtown Buffalo with Tim Jr. “With Father’s Day coming up,” he said, “it’s going to be tough on his dad.”

Source: Maki Becker, The Buffalo News [6/15/08]

NJ Podiatrist Has Ideal Solution to High Gas Prices

Now, whether it be for recreational, social or economic reasons, more and more Americans and more of your South Jersey neighbors are getting around on two wheels. Take Dr. David Carrozzino for example. The podiatrist said he regularly makes the trip from his Mantua home to his office in Woodbury on his Italian-made Vespa scooter and has done so for a decade.

Dr. David Carrozzino in Italy

"Ever since I was in Italy ten years ago, I knew I just had to have one," Carrozzino said. He just upgraded from his 50cc scooter to Vespa's top of the line Granturismo 200. The bike can keep up with most small cars with its 80 mph top speed. Carrozzino said his not-so-secret pleasure is to take a relaxing drive through some of the more scenic parts of Gloucester County when he's not making house calls.

Source: Lucas K. Murray, Gloucester County Times [6/16/08]

Motivate Employees By Providing Discounts to Local Merchants

Consider negotiating special prices or discounts for employees with businesses near your office.

Some possibilities: Restaurants, hair salons, dry cleaners, auto service and repairs shops, pharmacies, shoe stores, and gyms.

Source: Adapted from Meeting Manager's Workbook

Query: Charging for Prescription Renewals

In today's world of spiraling costs, excessive overhead, declining reimbursements, I am interested in what anyone has done to enhance their revenue. One idea I had would be to charge for prescription refills. I am inundated with faxes for medication refills that take time to pull a chart, review the chart and write the refill. Some are for patients whom I have not seem for quite a while and who get upset when I do not grant their refill without their being seen first. Has anyone done this?

Alan Mauser, DPM, Louisville, KY

Query: Coding Suture Removal Under Sedation

I performed extensive surgery on a 16 year old female under local anesthesia with IV sedation in my ambulatory center. She has a genuine "doctor anxiety," and has fainted almost every time she has been in the office, even when no procedures were performed.

When it came time for the suture removal, she and her parents insisted on IV sedation which was performed without incident today in an ASC with a nurse anesthetist.

In the above case, is the suture removal - which was above and beyond the usual suture removal - billable? If the answer is no, what/how would the anesthetist code the procedure performed in order to get paid?

Burton Katzen, DPM, Temple Hills, MD

You, as the surgeon, cannot be paid for suture removal. The nurse anesthetist would bill for administering sedation.

Mark Schilansky, DPM, Catskill NY

Codingline subscription information can be found by clicking here

RE: Candida Injections for Verruca (Neil Levin, DPM)
From: Ron Footer, DPM, Pete Harvey, DPM

I have used sub-lesional Candida injections for plantar verruca for several years. Candin, (Allermed Labs, San Diego, CA) comes in 10cc vials. Sublesional injection dose is 0.1cc mixed with 0.5cc of plain anesthesia. For multiple lesions, usually the primary lesion is the only one injected, but if the patient is unsure, several lesions may be injected at the same time. No other treatment is needed, and the patient returns in 3 weeks for debridement and re-injection if needed. If it works, in 1-3 injections, the lesions simply go away. Generally my personal success rate for recalcitrant lesions is 80-85%, understanding that Candin injections are not the primary mode of therapy for patients with one or two lesions.

Ron Footer, DPM, Gaithersburg, MD, drfooter@comcast.net

Candin is expensive and not a first line treatment. Be thoroughly familiar with possible side-effects including allergic reaction. Following local anesthesia, I use a tuberculin syringe with a 30g needle. I have one case I'm treating with 80% effectiveness.

Pete Harvey, DPM, Wichita Falls, TX, pmh@wffeet.com

ASSOCIATE POSITION - QUEENS, NY

Associate position leading to partnership. Seeking highly motivated and personable individual, for busy, well-established practice in western Queens. Prefer PSR-36 trained. Must be willing to address all phases of a busy podiatric practice. Please provide references w/ CV. Fax# 516-829-2537, or e-mail to lpbbdw@aol.com

IMMEDIATE OPENING – CHATTANOOGA, TN

Excellent opportunity for a young well-trained personable podiatrist to join a rapidly growing practice. $100,000 salary. PSR-36 minimum required. Live, work and play in a beautiful area with many recreational opportunities including rock climbing, hang-gliding, whitewater paddling, fishing, boating, etc. Option for partnership/ownership track. No nursing homes. No weekends. E-mail cover letter and CV to drsegler@anklecenter.com

PODIATRISTS NEEDED - CHICAGO --NORTHWEST INDIANA

Home Physicians, a medical group specializing in house calls is looking to hire podiatrists. We are located in Chicago and Northwest Indiana. Full and part time positions are available. Competitive Compensation including malpractice. Contact Scott Schneider. Phone-773-342-4201 FAX 773-486-3548-E-Mail sschneider@homephysicians.com Visit our website

ASSOCIATE POSITION - SAN ANTONIO, TEXAS

Seeking three-year trained resident for associateship, hopefully leading to partnership. Competent in all phases of podiatry particularly reconstructive rearfoot surgery. Outstanding opportunity for the right individual. Reply to Richard Pollak at 210-692-0279, or fax resume to 210-692-0028 or e-mail drpllk@hotmail.com

ASSOCIATE POSITION WITH OPPORTUNITY FOR PARTNERSHIP NY/PA

Group practice located on NY-PA border with excellent growth in the area’s industrial, retail, and college campuses. Surgical privileges in medical centers in NY and PA. This position will involve rotating through multiple office locations, and wound care centers. Local insurance reimbursement involves mostly private pay PPO models. We are looking for an ABPS Board Qualified podiatrist to join our team. Candidates would need to obtain licenses in NY and PA, and become ABPS certified to maintain hospital privileges. Base salary starting at 85,000.00 with bonus plan incentive, vacation, and health/mp insurances. Forward CV to prefprovider@hotmail.com

ASSOCIATE POSITION – CHICAGO AREA

Join one of the most successful, long-established podiatry practices in the Chicago area, with excellent salary and benefits. We have an immediate opening for full-time podiatrist in a multi practice location in the Chicago land and Northwest Indiana area. Must have two years of surgical residency. Please e-mail resume to d-kitchens@footexperts.com

IMMEDIATE OPENING - MINNEAPOLIS, MN

Associate leading to partner in well-established practice. Seeking personable, skillful, and attentive podiatrist. No nursing homes, evenings or weekends. Competitive compensation package including health insurance, malpractice, short term disability, 401(k), generous vacation, paid holidays, and excellent salary plus bonus! E-mail cover letter and CV to jbremer@associatedpodiatrists.com or fax to (612) 866-5875 attn: Jennifer Bremer

ASSOCIATE POSITIONS – CALIFORNIA

Coast to Coast Mobile Podiatry Group, California's premier provider of mobile on-site health-care services is seeking hardworking, caring Associates to provide excellent health-care to the greater Los Angeles areas, Organge County, San Bernadino County, Riverside, San Diego, and Santa Barbara. Salary and benefits available. Please email you CV and salary request to coasttocoastpodiatry@yahoo.com

BIOMECHANICS FELLOWSHIP – NEW YORK

Neoteric Biomechanics (patent pending) Nine-Month Fellowship: At The Foot Typing Center® in New York City. Practice, Research, Publish and Credentialize Yourself In This New Paradigm. $36,000 Stipend. New York License Required.Fax Interest to: 212 288 3034 or apply to Dr. Shavelson @ drsha@lifestylepodiatry.com.

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